ABSTRACT
Introduction: Decision making in determining management of post-trauma patient is very important, especially for traumatic in the small bones, fingers and toes. The global predictor to determine the management of retaining or amputating the limb is using the Mangled Extrimity Severity Score (MESS) scoring system, values above 7 are the indication for amputation. The decision maker have to pay attention for the end result of the actions which were performed in the initial management. Material and Methods: One case is reported from Orthopaedic emergency department Hospital in Makassar, South Sulawesi, Indonesia. A 39-year old male with motor vehicle accident trauma at left foot region since 6 hours before admitted to hospital, later was diagnosed with open comminutive fracture shaft proximal phalang of left 5th toe, the Mangled Extrimity Severity Score (MESS) was 8. Patient underwent emergency debridement and retained the toe by performed Open Reduction Internal Fixation (ORIF) K-Wire. Results: This patient has a good clinical outcome by following up 2 weeks and 8 months after surgery by retain the affected side with debridement and Open Reduction Internal Fixation (ORIF) K-Wire. Patient can ambulate normally with full weight bearing, and there is no difficulty to wearing shoe or sandal. Conclusions: Determination of action by retaining the traumatized limb needs to be considered for the good of the patient, but it is necessary to provide informed consent to the patient and family that there will be a possibility of tissue death with the worst possibility of limb amputation
Subject(s)
Humans , Male , Adult , Toe Joint/surgery , Bone Wires , Injury Severity Score , Fractures, Comminuted/surgery , Foot Injuries/therapy , Debridement , Fracture Fixation, InternalABSTRACT
Objective Retrospectively investigate 76 cases of traumatic amputation and limb salvage so as to provide clinical reference for children amputation .Methods We retrospevtively investigated 38 cases of traumatic amputation admitted during July 1996 to May 2013(experimental group) ,and 38 cases of limb salvage cases at the same time(control group) ,and re‐evaluated them according to the MESS standards and LSI score .Statistical analysis of the two scoring systems for the inosculation of amputation was conducted .Results Both Mangled Extremity Severity Score and Limb‐salvage index system can be used as the estimation for the traumatic amputation .Conclusion Mangled Extremity Severity Score (MESS) and Limb‐salvage index (LSI) can be used as an evaluation of the traumatic amputation in children ,and LSI was more suitable for the children .
ABSTRACT
Objective To evaluate the role of mangled extremity severity score(MESS)in res-ervation and amputation of crush lower limbs in earthquake. Methods There were 122 patients with crush lower limb injuries,with MESS≥8 points in 34 patients who were primarily amputated,M ESS 5-7points in 19 who were principally preserved and MESS＜5 points in 69 who were preserved by means of debridement,external fixators,plast splints and vaeuum sealing drainage technique.Results All pa-tients were survived.with amputation rate of 29.5%. Conclusion MESS is an important reference for evaluation of reservation and amputation of crush limb injuries caused by earthquake.